DEATH, DOCTORS & GRIEF

Does anyone consider the role of a physician to be easy?

Presumably not. But in addition to the long hours, physical stress, concern over running a business, diminishing reimbursements, increasing governmental intervention, threat of malpractice law suits etc. etc. comes another "gift".

How does a physician handle the emotional turmoil that accompanies the role of being the source of life-altering information for our patients. And what about their own personal emotional challenges? Are they in any way better equipped to deal with them than anyone else?

In the NYTimes article http://www.nytimes.com/2012/05/27/opinion/sunday/when-doctors-grieve.html the author attempts to address the issue. There is no doubt that we struggle with having to give bad news to our patients. We struggle with the knowledge they will be facing a frightening, uncomfortable and often futile course of medical or surgical treatment. Some of us choose to drop the bad news all at once. Others attempt to reveal distressing diagnoses and information in small, digestible increments. We,too, struggle with the great metaphysical issues that challenge all human beings–how to deal with suffering and death.

Our own insecurities and personal histories will impact how handle each unique situation. And what do we do with our own emotions? We clearly can't show them. We often retreat behind our white coats and grim faces. We know that we can be influenced by our own personal confusion and angst over our own deaths and of those we love.

And yet we are human beings. We are imperfect and vulnerable just like everyone else. We suffer, we grieve and we do feel the pain that our messages deliver to our patients. But that awareness might even disturb our patients.

It is an interesting phenomenon. Patients often seek to peel away the professional veneer we wear and to find out a little about our personal lives. Yet do they really want us to reveal our frailties as well? I wonder.

I have always believed that medical education woefully prepares individuals for the task of practicing medicine. We kind of "wing it". We try to use common sense and good judgment. But it is all improvisation. I do believe it is necessary for physicians to look within themselves. We need to experiment with self-reflection.

What are our personal beliefs regarding death and dying? How can we deal with delivering terrible news to another human being? Do we have the tools to do so? Not really. Some of us are inherently better at the task than others. Some of us find a way to mix compassion with professionalism. It is far from easy. I'm not sure anyone can teach us how to do it. But we should finally address the issue fully and openly.

Facing deep, troubling metaphysical issues are not easy for any of us. Physicians are not better equiped to deal with them than anyone else.

We need to be better at it. It is part of what we do. It sets us apart from how most individuals live their lives. And how we do it truly matters.

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